A comparison of three-year survival after coronary artery bypass graft surgery and percutaneous transluminal coronary angioplasty
A comparison of three-year survival after coronary artery bypass graft surgery and percutaneous transluminal coronary angioplasty
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DOI：
10.1016/s0735-1097(98)00540-3
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发表时间：
1999-01-01
影响因子：
24
通讯作者：
Jones, RH
中科院分区：
文献类型：
--
作者：
Hannan, EL;Racz, MJ;Jones, RH
目标。本研究的目的是比较接受冠状动脉旁路移植术 (CABG) 手术和经皮腔内冠状动脉成形术的患者的 3 年风险调整生存率。冠状动脉搭桥手术和血管成形术是冠状动脉疾病的常见治疗方法。出于转诊目的，了解这些手术出院后的相对生存模式并确定与生存相关的患者特征非常重要。纽约的CABG手术和血管成形术登记处用于识别1993年1月1日至1995年12月31日期间接受CABG手术和血管成形术的纽约患者，并记录了接受手术后3年内的死亡率（根据患者疾病的严重程度进行调整）以及随后3年内的血运重建。使用比例风险方法调整三年死亡率，以考虑患者疾病严重程度的基线差异。结果。患有单支血管疾病且其中一根血管不涉及左前降支 (LAD) 或 LAD 狭窄小于 70% 的患者，接受血管成形术 (95.3%) 的调整后 3 年生存率在统计学上显着高于接受 CABG 手术 (92.4%) 的患者。无论病变冠状血管的数量如何，近端 LAD 狭窄至少 70% 的患者经 CABG 手术后的调整 3 年生存率在统计学上显着高于血管成形术。此外，无论近端 LAD 疾病如何，患有三支血管疾病的患者经 CABG 手术后调整后 3 年生存率在统计学上显着更长。患有其他单支或多支血管疾病的患者在生存方面没有治疗相关的差异。结论。缺血性心脏病患者的 3 年治疗相关生存获益是通过疾病的解剖范围和具体部位以及所选择的治疗来预测的。 (C) 1998 年由美国心脏病学会发布。
Objectives. The purpose of this study was to compare 3-year risk-adjusted survival in patients undergoing coronary artery bypass graft (CABG) surgery and percutaneous transluminal coronary angioplasty,Background. Coronary artery bypass graft surgery and angio plasty are he common treatments for coronary artery disease. For referral purposes, it is important to know the relative pattern of survival after hospital discharge for these procedures and to identify patient characteristics that are related to survival,Methods. New York's CABG surgery and angioplasty registries were used to identify New York patients undergoing CABG surgery and angioplasty from January 1, 1993 to December 31, 1995, Mortality within 3 years of undergoing the procedure (adjusted for patient severity of illness) and subsequent revascularization within 3 years were captured. Three year mortality rates were adjusted using proportional hazards methods to account for baseline differences in patients' severity of illness.Results. Patients with one-vessel disease with the one vessel not involving the left anterior descending artery (LAD) or with less than 70% LAD stenosis had a statistically significantly longer adjusted 3-year survival with angioplasty (95.3%) than with CABG surgery (92.4%). Patients with proximal LAD stenosis of at least 70% had a statistically significantly longer adjusted 3-year survival with CABG surgery than with angioplasty regardless of the number of coronary vessels diseased, Also, patients with three-vessel disease had a statistically significantly longer adjusted 3-year survival with CABG surgery regardless of proximal LAD disease. Patients with other one-vessel or he-vessel disease had no treatment-related differences in survival.Conclusions. Treatment-related survival benefit at 3-years in patients with ischemic heart disease is predicted by the anatomic extent and specific site of the disease, as well as by the treatment chosen. (C) 1998 by the American College of Cardiology.